Published by Bupa's Health Information Team, March 2011.
This factsheet is for people who are having lymph nodes removed (lymphadenectomy), or who would like information about it.
Lymph nodes (or glands) are part of the body’s natural defence system called the lymphatic system. Sometimes doctors need to remove lymph nodes in certain parts of the body to help plan the best course of cancer treatment.
You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.
Lymph nodes are small kidney bean-shaped organs located throughout your body particularly in your armpits, neck and groin. Their main function is to fight infection and filter lymphatic fluid. You may be able to feel swollen nodes in your neck if you have a throat infection or tooth abscess.
Your surgeon may recommend having certain lymph nodes removed to help reach a diagnosis or give more information about a condition you already have. Causes of enlarged nodes include:
If you have cancer, your surgeon may remove lymph nodes closest to the tumour to find out if the cancer has spread – for example, in breast cancer or womb cancer. This is known as cancer staging.
Depending on the size and location of your cancer, your surgeon may remove the lymph nodes at the same time as removing the primary tumour (for example, in some types of breast cancer the surgeon removes the lymph nodes in the armpit at the same time as the breast tumour).
Your surgeon may suggest having a sentinel lymph node biopsy to help identify the first lymph node that tumour cells drain into. He or she will remove the sentinel lymph node and it will be tested for cancer. If no cancer cells are found, it means the cancer hasn’t spread to the lymph nodes and you won’t need unnecessary treatment.
Your surgeon will explain how to prepare for your procedure. For example, if you smoke, you will be asked to stop as smoking increases your risk of getting a chest and wound infection, which can slow your recovery.
Depending on your individual needs you may need to stay in hospital for up to three days.
Lymph nodes are usually removed under general anaesthesia. This means you will be asleep during the procedure. You will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your anaesthetist’s advice.
Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.
Your nurse will prepare you for theatre. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. To help reduce your risk of getting an infection after your operation, you may be given antibiotics by injection before having surgery.
The operation may take up to 45 minutes. There are two main surgical options for removing lymph nodes.
Your surgeon will make a small cut over the lymph node area. He or she will remove the lymph nodes and send them to a laboratory for testing. Your surgeon will close the cut with dissolvable stitches.
The operation is done through small cuts to reach lymph nodes deeper inside your body. Your surgeon will use special instruments to pass through these cuts and look at a monitor to see your lymph nodes.
Keyhole surgery isn’t suitable for everybody – your surgeon will advise you if it’s appropriate for you.
Your lymph nodes will be sent to a laboratory for testing to determine the type of cells and if these are benign (not cancerous) or cancerous.
You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
You may have fine tubes running out from your wound. These drain fluid into a bag and are usually removed after a day or two. You may be given the option to go home with the tubes still in place and have them removed later at your follow-up appointment or by a district nurse.
You will have a dressing covering your wound. This is usually removed on the second day. You will then be able to take a shower or bath.
The length of time your dissolvable stitches take to disappear depends on what type you have. However, for this procedure they should usually disappear in about seven to 10 days.
If you have lymph nodes removed from under your armpit or groin area, a physiotherapist (a health professional who specialises in maintaining and improving movement and mobility) will teach you exercises designed to help your recovery.
You will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours after you get home.
Your nurse will give you some advice about caring for your healing wounds before you go home. You will be given a date for a follow-up appointment.
Your results will be ready several days later and will usually be sent in a report to the doctor who requested your procedure. Your doctor will review the results and discuss them with you at your follow-up appointment.
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drink alcohol, operate machinery or sign legal documents for 24 hours afterwards.
You shouldn’t drive until you are confident that you could perform an emergency stop without discomfort. If you are in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your surgeon’s advice.
There are some important things to remember while recovering from having lymph nodes removed.
Contact your doctor for advice if:
You may have developed an infection and may need antibiotics to treat it.
As with every procedure, there are some risks associated with having lymph nodes removed. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.
Side-effects are the unwanted but mostly temporary effects you may get after having the procedure – for example, feeling sick as a result of the general anaesthetic. Side-effects of having lymph nodes removed include:
Complications are when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, infection, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Specific complications of having lymph nodes removed are uncommon but can include:
For answers to frequently asked questions on this topic, see Common questions.
For sources and links to further information, see Resources.
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This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
Publication date: March 2011
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